Health Care & Medicare

Plan for health insurance before 65, and Medicare after

Health insurance is the cost most early-retirement plans leave out. Retire before 65 and you buy your own coverage. In 2026 the enhanced subsidies expired and the 400% income cliff is back, so a few extra dollars of income can cost you thousands in lost premium tax credits.

Turn on the Health Care box and your plan prices the marketplace premium and the tax credit your income earns, every year, for each of you, until Medicare takes over. From then on, Medicare premiums and IRMAA surcharges are charged automatically, and an HSA can pay them.

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Health care before and after 65, in 18 seconds, on Chris and Jamie's example plan.
Healthcare expenses and HSA balance by age: marketplace premiums from 62 to 66, then Medicare paid tax-free from the HSA until its balance runs out at about 75, then Medicare and IRMAA paid from other accounts to 94

What Chris and Jamie, a made-up couple we use in our examples, pay for health insurance each year: marketplace premiums from 62, then Medicare, paid by their HSA until it runs dry and by their other accounts after that.

Before 65

Marketplace premiums, and the credit your income earns

Switch on Model ACA premiums and subsidies in the Health Care box. Each of you is then charged a marketplace premium from your own retirement until the month before your 65th birthday, less the premium tax credit your income qualifies for. A person still working is assumed to have coverage from work.

Every year, for each of you, the plan works out:

  • The benchmark (second-lowest silver) premium: the national average for your ages, or today's figure for your household from healthcare.gov
  • The credit that year's income earns, estimated each January and settled when the tax year ends, as on a tax return
  • Your state's Medicaid rules below the subsidy range, and no credit at all above 400% of the poverty level

The income that counts includes pre-tax withdrawals, Roth conversions, realized gains, interest, dividends and all of your Social Security. Spending cash, or money from a Roth account, does not. The Learning Library's interactive guide, Health Insurance Before Medicare, shows where one extra dollar can cost thousands, starting from your own plan.

When your income crosses the subsidy line, the Coach flags it and points you to the Optimizer's ACA subsidy limit target, so you can see whether staying under the line is worth it.

A Coach card marked Risk: Your income exceeds the ACA subsidy limit before Medicare. In 4 pre-65 years, ages 62 to 64, income is above the 400% of poverty level limit, about $94,957 for a household of 2. What you can do: try the ACA subsidy limit target in the Optimizer, with an Open the Optimizer button.

The Coach caught Chris and Jamie's subsidy cliff: four years before Medicare with income above the line.

The Healthcare and HSA chart by age: COBRA premiums at 62 and 63, marketplace premiums to 66, healthcare and Medicare paid from the HSA until it runs out at 70, then from other accounts, with the HSA balance as a line

Chris and Jamie's health costs with COBRA first, then the marketplace, then Medicare.

Bridges and Retiree Plans

COBRA, an employer plan, or a plan for life

Not everyone goes straight to the marketplace. Under Retiree and COBRA coverage, add up to two arrangements, each with who it covers, the type of plan and one monthly premium in today's dollars.

  • COBRA, a retiree plan or a working spouse's plan as a bridge: while it covers someone, the marketplace charges them nothing, then takes over the month it ends
  • End it after a number of months, at an age, at Medicare, or when your spouse retires
  • Federal (FEHB), postal (PSHB) and TRICARE retiree plans, and many state, school and company plans, can run for life alongside Medicare

For a plan you keep with Medicare, choose the Medicare parts it works with, enter any Part B amount it pays back, and set how much faster than inflation its premium rises. A line under each arrangement confirms the dates in plain words.

Medicare, automatically

For each of you, the Medicare Part B premium and the base Part D premium are charged from the month of your 65th birthday, rising with your plan's inflation. There is nothing to switch on.

  • IRMAA when income calls for it: set by your income two years earlier, so a big Roth conversion at 63 raises your premiums at 65
  • For each of you: each person on Medicare pays the surcharge, with tiers that start above $109,000 for a single person and $218,000 for a married couple filing jointly (2026)

To stay under a tier, the Roth Conversions box can fill conversions up to the IRMAA threshold.

Your own Medicare age

Staying on an employer plan past 65, your own or a working spouse's? Set the age Medicare actually starts for that person. Until then the plan charges them no Medicare premium and no IRMAA.

Medicare can also start before 65, after 24 months of Social Security disability benefits, or with kidney failure or ALS. Enter that age, and from then the plan charges Medicare, ends that person's marketplace coverage, and stops their HSA contributions.

Let your HSA pay

Have a health savings account? From its owner's 65th birthday it pays your Medicare premiums, your spouse's too, tax-free, in months the plan would otherwise draw on your investments.

Add the HSA box for more control: healthcare spending paid from the HSA in retirement at its own healthcare inflation rate, contributions up to the yearly limit, and when they stop.

Beyond Premiums

What to add yourself

The planner charges the standard Medicare premiums. Add these to your spending or your budget:

  • A Medicare supplement (Medigap), or what a Medicare Advantage or Part D plan costs above the base amount
  • Dental, vision and hearing, and out-of-pocket costs like deductibles, copays and prescriptions
  • Long-term care late in life, as a budget row or a milestone at either person's age

Premiums the planner charges are paid on top of your spending, so keep them out of your spending and budget to avoid counting them twice. New to Medicare? Read our Medicare 101 guide.

Where It Applies

Built for US plans

Marketplace coverage, Medicare, IRMAA and the Health Care and HSA boxes are for US plans only.

Planning somewhere else? Add health insurance, care and out-of-pocket costs to your spending or your budget. In Canada, the Ontario Health Premium is included in Ontario provincial tax.

Planning in Canada  ·  Planning in the UK

Preview Free to get started

  • The Health Care box: marketplace premiums and tax credits, COBRA and retiree coverage, and your Medicare start age
  • The HSA box: healthcare spending and Medicare premiums paid from your HSA
  • Medicare and IRMAA in your projection from 65, with nothing to switch on
  • The Learning Library guide Health Insurance Before Medicare

Planner+ Planner+ adds

  • The Healthcare & HSA chart, and health costs on the Taxes and Spending charts
  • Your Taxes, with lifetime Medicare and IRMAA
  • The Summary's Income thresholds card, and the Coach
  • Long-term care as a budget row or a milestone
Want every detail? Read the full guide, Health care costs before and after 65, in our help center. Read the guide

Estimates, not quotes

The planner charges the benchmark marketplace premium less your estimated credit, and the standard Medicare premiums. The plan you choose, where you live and each year's rules will change what you really pay. Marketplace and Medicare modeling is for US plans. Ready Aim Retire is an educational tool, not tax, insurance or investment advice.

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